Diagnosis of Histoplasmosis by Antigen Detection in BAL Fluid

Hage, Chadi A.; Davis, Thomas E.; Fuller, D.; Egan, Lindsey; Witt, John R.; Wheat, L. Joseph; Knox, Kenneth S.

doi:10.1378/chest.09-1702

Cited by 110 publications

(88 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An earlier study among HIV/AIDS patients showed a BAL fluid Histoplasma antigen sensitivity of 70% compared to 93% in urine and 88.5% in serum (17). However, in a more recent study, the sensitivity of BAL fluid antigen testing was superior (93%) to those of both urine (79%) and serum (65%) and identified cases that were missed by the urine and serum methods (9). In patients with Histoplasma meningitis, antigen may be detected in the CSF, with a sensitivity ranging from 40% to 65% (18,19).…”

Section: Antigen Detectionmentioning

confidence: 88%

“…Cytopathologic evaluation of bronchoalveolar lavage (BAL) fluid is relatively noninvasive and has a sensitivity of around 50% for acute pulmonary histoplasmosis. When combined with BAL fluid Histoplasma antigen testing, the sensitivity rises to 97% (9). Fine-needle aspiration is another safe diagnostic method that can yield a cytodiagnosis of histoplasmosis when applied to a variety of tissues, including lymph nodes and adrenal glands (10).…”

Section: Cytopathologymentioning

confidence: 99%

See 1 more Smart Citation

Laboratory Diagnostics for Histoplasmosis

2017

Self Cite

View full text Add to dashboard Cite

The diagnosis of histoplasmosis is based on a multifaceted approach that includes clinical, radiographic, and laboratory evidence of disease. The gold standards for laboratory diagnosis include demonstration of yeast on pathological examination of tissue and isolation of the mold in the culture of clinical specimens; however, antigen detection has provided a rapid, noninvasive, and highly sensitive method for diagnosis and is a useful marker of treatment response. Molecular methods with improved sensitivity on clinical specimens are being developed but are not yet ready for widespread clinical use. This review synthesizes currently available laboratory diagnostics for histoplasmosis, with an emphasis on complexities of testing and performance in various clinical contexts.

show abstract

Section: Antigen Detectionmentioning

confidence: 88%

Section: Cytopathologymentioning

confidence: 99%

Laboratory Diagnostics for Histoplasmosis

2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Detection of antigen in bronchoalveolar lavage fluid (BAL) [14] and cerebrospinal fluid (CSF) [15] may provide the sole basis for diagnosis in some cases. Antigen was detected in BAL in 93 % of patients, while histopathology and/or cytopathology was positive in 30 %, antigenuria in 79 % and antigenemia in 65 % [14].…”

Section: Antigen Detectionmentioning

confidence: 99%

“…Antigen was detected in BAL in 93 % of patients, while histopathology and/or cytopathology was positive in 30 %, antigenuria in 79 % and antigenemia in 65 % [14]. In early reports, antigen was detected in the CSF in 25-50 % of patients with CNS disease [16].…”

Section: Antigen Detectionmentioning

confidence: 99%

Approach to the Diagnosis of Histoplasmosis, Blastomycosis and Coccidioidomycosis

Wheat¹,

Knox

Hage

2014

Curr Treat Options Infect Dis

Self Cite

View full text Add to dashboard Cite

“…Because yeast forms of the fungus may remain viable within granulomas formed after successful treatment or spontaneous resolution of infection, late relapse can occur if cellular immune function wanes, although the magnitude of this risk appears very low. 1 Infection can occur during pregnancy, and transplacental infection has rarely been reported. 2 …”

Section: Histoplasmosis (Last Updated November 6 2013; Last Reviewedmentioning

confidence: 99%